Tajammal Abbas Shah.
Colonic cancer; presentation and management in a surgical unit at Allied hospital Faisalabad.
Professional Med J Jan ;23(03):251-6.

A prospective study was conducted to see presentation and management of colonic cancer presenting to a surgical unit in a teaching hospital at Faisalabad. Objectives: To know different presenting symptomatology like abdominal mass, pain, intestinal obstruction, altered bowel habits, rectal bleeding, age co-relation, sex distribution, anatomic location among colonic cancer patients and management done for these patients. Study Design: A prospective study. Period: February 2009 to March 2010 for one year. Material and Methods: Total 8 patients were diagnosed and treated for colonic cancer presenting in a single surgical ward. Patients with age above 14 years were included in study while patients presenting with trauma and metastatic disease for other carcinoma were excluded. Results: Among 8 patients diagnosed for colonic cancer, age’s range from 26 to 50 years at maximum, 2 patients (25 %) were males and 6 patients (75 %) were females. Only one patient (12.5%) presented with single complaint of left iliac fossa mass, 2 patients (25 %) with only single complaint of rectal bleeding as a presenting symptom while all other 5 patients (62.5%) presented with more than one or two symptoms at the same time. Among 5 patients presented with more than one symptom all had presented with abdominal mass associated with additional symptoms like, one patient (12.5%) developed intestinal obstruction with left sided abdominal mass, another one patient (12.5%) left sided abdominal mass with alternate diarrhea and constipation, another one patient (12.5%) right sided mass with pallor, one patient (12.5%) had constipation with left sided mass while another one patient (12.5%) developed abdominal pain, weight loss and palpable left sided abdominal mass. Patients were staged according to TNM staging system. All patients were above stage II and Dukes B. All patients were operated in Surgical Unit II at Allied Hospital Faisalabad. Left hemi-colectomy was done for 2 patients; right hemi-colectomy was done for single patient presented with mass and anemia on right side, sigmoid resection with colostomy for one patient, Hartmann’s procedure for another one patient and single stage resection with primary anastomosis for one patient. 2 patients underwent abdomino-perineal resection with end colostomy. Conclusion: This study tells that majority of the patients with colon cancer presented with left sided abdominal mass and other associated symptom, the age’s range from 26 to 50 years. Disease affected 6 females out of total 8 patients. Two patients underwent APR with end colostomy while other patients were treated with alternate procedures like primary anterior resection with anastomosis or end colostomy

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